Dr Lasermed is a grumpy gynecologist who comments about her practice, the state of medicine, women's health care and her triplet children.

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These are the thoughts of a cantankerous ol' gynecologist who remembers when things were a little different. I try to find a little humor in my life and the people I meet along the way. Come meet the characters in my world.

Wednesday, October 5, 2011

Medical Office Quandaries #3

You Have to TAKE the Medication

I really don’t understand a lot of patients.The longer I do this, the more confused I get.Maybe you can explain this to me:

I had a patient who came in recently with pelvic pain and period problems.I’m sure she wanted narcotics.I explained that she had to try other things first.This ain’t my first rodeo, folks.To make a long story short, I did the usual: a complete history and physical including Pap smear, sent for old records, gave her a prescription for birth control pills and for a NSAID (medications in the Motrin family).

I also ran a urine drug screen on her.I ask all the women I do this for EXACTLY what controlled substances I’m going to find in the urine.I tell them not to lie to me, or they will not be able to get anything stronger than NSAIDS.Do they listen?

This patient’s urine had two drugs she had “forgotten” to tell me about.Strike 1.

Her records didn’t exactly tell me the same story that she did.She had gotten controlled substances at two of the places she had been before she came to me.Strike 2.She also has a low potassium level that could cause a heart irregularity.This is in her records from an ER visit.We tried to get in touch with her to tell her about this, but none of her phone numbers worked.She gave us six numbers.

When she came back for her follow-up visit, she said she gave her prescriptions to her mother to fill.Her mother lost them, so she had not taken them.Strike three.

What did I do?

First, I gave her a lecture.I was mad.I gave her a list of high potassium foods and told her she needed to see her medical doctor.I rewrote the prescriptions.I explained that she had to take them and see what happened.I refuse to “throw narcotics” at a problem that we have not defined.Besides, she could have a major heart problem with the narcotics and the low potassium together.

Do I think she will listen?I doubt it.She didn’t get what she wanted.She got what she needed, but that doesn’t always matter to patients these days.

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The band my kids march in

Characters

I'm Dr. Lasermed. I'm a Gynecologist (that's a doctor that takes care of women and women's problems). I've been in private practice for over a quarter of a century.Mr. Lasermed - a paramedic in his former life, married me without fully realizing how crazy it is to have a physician for a spouseThe Lasermed children (triplet boys):Mr. Impatient - sweet, lovable and impatient. Autistic and very bright. He loves sports (all kinds). He is also very routine oriented.Three Speed- originally two speed - slow and stop. However, has ADD, so third speed is "....look, there's a bunny". Very bright when we can get him to focus. Plays trumpet.Tall Guy- First one to be taller than Mom - calls me "short woman" - probably the smartest of the three - definitely the most sarcastic. Plays the baritone (and alto) saxophone.Princess – my faithful and kind receptionist who puts up with me when I’m cranky and puts up with my patients who are crazy. She has two wonderful boys and a boyfriend and Mom who may or may not appear in the blog.Yearbook Gal – Tall Guy’s girlfriend and photographer for the yearbook.Computer Geek - formerly had a name, now changed at his request because he wanted a nickname, too. He helps me out when I get stuck with the computer issues.

About Me

I am a Gynecologist (a doctor who cares for women and women's problems). I went to medical school in the south, residency in the frozen north (with a small side trip to Canada), then moved to a "medically underserved area" I have endured riots, hurricaines, tornados, floods and triplets.
My triplet boys are about finished with high school. Two of them are in the marching band. See the photo. I am very proud of them.
I also write as Dr. Maryellen Smith on associatedcontent.com Follow me on twitter @ lasermed1
I appreciate feedback.

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Techno - Idiot.

I would like to state for the record that any and all mistakes are those of the blogger. I am in my mid-50s. When I was first introduced to computers, I actually punched cards. I never figured out how to write in all those funny languages. I have recently tried to post pictures with my articles. Nope. I forget to put tags on posts. Sorry. Be patient with me. I will eventually get it. I am trainable.

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Disclaimer

*****This blog is not intended to give medical advice. You should always check with your doctor. Note I did not say "provider". You should read the blog to see why.

Any resemblance of characters to people you think you might know, living or dead, is totally coincidental. Really. Unless I asked them if I could use the story. Even then, details have been changed to protect somebody.

I can't ask about places. Soooooo..... Any resemblance of places to someplace you think you know is absolutely coincidental.